Probe for medical use

ABSTRACT

A probe for medical use comprising a tube ( 1 ) and a cuff ( 3 ) located around the tube ( 1 ) in a region of its external wall, the cuff ( 3 ) being inflatable through a conduit ( 5 ) arranged at the wall of the tube ( 1 ), linking the interior of the tube ( 1 ) to the interior of the cuff ( 3 ), the inflation and deflation of the cuff ( 3 ) being determined by the rhythms of the inspiration and expiration of air, respectively.

CROSS REFERENCE TO RELATED APPLICATION(S)

This application is a continuation-in-part of U.S. patent applicationSer. No. 10/566,208, filed May 16, 2008, which was the National StateEntry of PCT/BR2003/000109, filed Jul. 28, 2003, both of which areincorporated by reference as if fully set forth.

FIELD OF INVENTION

The present invention relates to a probe for intubation of patients inseveral medical/surgical procedures (for example, oro- and nasotracheal,tracheostomy intubation probe, etc.) of the type basically consisting ofa tube through which air is supplied into a patient's body, and aninflatable cuff used for preventing extravasation of the supplied air,causing the air flow to go in and out always through the tube (and notthrough the region between the tube and the intubated tubular organ);for controlling the internal pressure of the airways and further forfixing the probe to the walls of a passageway of the human body, andlocated around part of the external wall of the tube.

BACKGROUND

Several types of probes, which are used for intubating patients, areknown.

A serious drawback of the probes of the prior art is that said cuff,which accounts for fixing the probe at a determined place on the humanbody, remains inflated throughout the intubating period, which may causeinjuries to the patients if said period is prolonged, by reason of thetotal or partial stoppage of blood circulation in the region where thecuff exerts pressure on the walls of the passageway of the human bodywhere the intubation is made, for example, the trachea of a patient.Moreover, in some cases, the cuff is inflated by inserting a fluid(usually iodine) into it by means of a syringe. This procedure is notcarried out in a totally precise and safe way. Excessive inflation ofthe cuff is another factor that contributes to the occurrence of saidmentioned injuries.

Moreover, in the case of the probes of the prior art, the conformationof the probe for introduction into the human body is carried out withthe help of a metallic thread, inserted into the probe tube. Theinsertion of the metallic thread into the probe tube may damage someorgan or some tissue of the patient, in case the metallic thread exceedsthe length of the probe tube.

U.S. Pat. No. 4,697,574 deals with a coronary and circulatory assistancepump that uses cuffs for blocking the aorta and the coronary arteries indiastole. According to that patent, the passageway for blood from theaorta is kept opened by means of a system of two cuffs that aresequentially inflated and deflated, the sequence being determined bysignals from an electrocardiogram apparatus, which are used as commandsfor sequentially inflating and deflating the two cuffs for the purposeof never interrupting the flow of blood in the aorta, which wouldobviously cause the death of the patient. This solution, however,besides being specific for use in the aorta, is of technically complexconstruction, needing two cuffs and, chiefly, imposing an artificialrhythm of opening and closing the blood-circulation passageway, which isundesirable from the physiological point of view.

U.S. Pat. No. 4,791,923 deals with a tracheal probe composed of an outercuff and an inner cuff, the latter being located inside the outer cuff,said cuffs being non-physiologically inflated by conduits. Since theyare very thin, they only work under high pressure; besides, these cuffsdo not inflate, if they are connected to the lumen of the tube. Thisprobe has the purpose of sealing the trachea completely with the outercuff during inspiration and expiration in pressure peaks, withoutletting the gases leak. However, due to the elasticity of the tracheaand its consequent dilatation, the inflated gases leak.

EP-A-0,766,976 describes a probe with only a suction system that onlysucks the interior of the tube. This probe prevents contamination andrespiratory problems during the suctions, as well as carries out thesesuctions uninterruptedly. Since it has an internal cannula foruninterrupted suction, the probe lumen is reduced. Said probe dispenseswith the use of a connector with the Y for introduction of the suctioncatheter.

WO-A-99/38548 deals with a probe that has a lumen dedicated to thesuction trigger for aspirating secretions from the trachea. This probedoes not have a valve, or tap, for connection of the internal andexternal aspirations; these aspirations could be effected simultaneouslyor alternatively, in case the probe had a valve.

U.S. Pat. No. 5,452,716 describes a tracheal tube for assisting thebreathing of patients with respiratory insufficiency, as long as theyare with their breathing under control.

Document WO-A-99/66975 describes an intratracheal ventilation catheter.In this catheter, the whole sucked air passes through the cuff, with theair flowing to the distal end of the catheter until it reaches thetrachea, and the expired air is made outside the tube. In thisinstrument, the outlet for air from the cuff is the same air inlet.

U.S. Pat. No. 6,463,927 describes a guide for an endotracheal tube madefrom a plastic material containing a bendable rod.

FR-A-2,826,283 deals with an endotracheal medical surgical probeadaptable only to the morphologies of oral regions and external segmentsof the patients' mouth.

OBJECTIVES OF THE INVENTION

An objective of the present invention is to prevent injuries caused byprolonged intubation of a patient with a probe provided with aninflatable cuff.

Another objective of the present invention is to provide moretranquility to the physician in performing surgeries that require alonger time for intubating the patient, as well as to provide a probesuitable for facilitating intubation in emergency situations.

A further objective of the present invention is to prevent possibleinjuries caused by inserting the metallic thread into the tube in orderto conform the probe.

The invention also has the objective of preventing the use of alaryngoscope.

A further objective of the present invention is to prevent the cuff frombeing excessively inflated, which would cause injuries to the patient.

Another objective of the invention is to provide a probe especially forpatients who remain intubated for a long time, independent of itsduration.

The above-described objectives of the invention are achieved by means ofthe probe that will be described in greater detail later.

SUMMARY

The present invention has achieved the above-cited objectives by meansof a probe for medical use, which basically consists of a tube designedfor receiving blown air, and a first cuff arranged around the tube in aregion of its external wall, said first cuff being inflatable by meansof a first conduit located at the tube wall, which account forcommunication of the inside of the first cuff with the inside of thetube. Thus, the insufflation of the first cuff is commanded by the flowof air injected into the tube during the inspiratory movement, causingthe probe to be fixed to the walls of the passageway of the human bodythat is being intubated; whereas the deflation of said first cuff takesplace when the air is expelled from the patient's lung through the tubeduring the expiratory movement. This causes the first cuff to deflatetemporarily, thus alleviating the mechanical pressure on the walls ofsaid passageway of the human body and making blood circulation possibleuntil a new flow of air is injected, which may come from an artificialbreathing apparatus or from the normal breathing of the patient.

Thus, said first cuff is inflated during the inspiration and deflatedduring the expiration at the natural rhythm of the patient's respirationor artificial breathing apparatus. In this way the above-mentionedproblems of the prior art are eliminated and the probe of the presentinvention has an ideal performance from the physiological point of view.Further, said first cuff may be inflated from a conduit that is notconnected to the tube lumen, but rather to one of the legs of the Yconnector, connected to the probe or else directly from a source comingfrom the respirator or another mechanism that follows the same cycle ofthe respirator.

According to a preferred embodiment of the invention, the probe furthercomprises means that provide the tube with an elastic memory, located onthe tube wall and consisting of a guide thread made from a radiopaqueflexible and malleable material. Such means simultaneously allow one tomold the probe tube and to view the probe on an X-ray photograph, forinstance, besides enabling one to mold the probe, adapting its exit tothe mouth, nose or tracheostomy orifice, to prevent known lesions causedby probes to lips, gums, teeth, tongue, nose wings and neighboringstructures of the tracheotomies. These means having elastic memoryenable a simple, rapid non-traumatic intubation, and even withoutlaryngoscope.

According to another embodiment of the invention, the probe for medicaluse comprises, in addition to the tube, the first cuff and the firstconduit in the tube wall that communicates the interior of the tube withthe interior of the cuff, a second and a third conduits in the tubewall, which extend along the length of the tube and are to be coupled toan external aspiration device.

The second conduit has bores close to an end, which providecommunication of the inside of the second conduit with the inside of thetube, the other end being connectable to a suction device, thus allowingthe secretions existing inside the probe tube to be sucked, whichprevents the tube from being clogged. The orifices remain in the backwall of the tube 1, at a distance of 1 centimeter from each other andextend from the cuff to the distal end of the tube. Their diameters areequal to or smaller than that of the conduit that has given rise tothem.

The third conduit, on its turn, has bores close to one of its ends,which provide communication of the inside of the third conduit with theexternal region of the tube, the other end being connectable to asuction device, so that the secretions existing inside the tube can alsobe sucked. The orifices also remain in the back wall of the tube that isrelated to the back wall of the trachea, have a diameter equal to orsmaller than that of the conduit that has given rise to them, and are innumber of three in the oropharynx and three in the trachea, over thecuff 1 by one centimeter when the latter is totally inflated, and areaway from each other by 1.5 centimeters.

In addition, the second and third conduits are connectable by their endsto a first 3-way connection means, coupled to the external suctiondevice and provided with a switch that permits suction at each of theconduits separately or at both conduits at the same time. In this way,depending upon the position of the switch, either the secretionsexisting inside the tube alone can be sucked (through the secondconduit) or the secretions existing in the external region of the tube(through the third conduit), as well as the secretions of both regionsat the same time.

According to an embodiment of the present invention, the first conduitis connectable to a second 3-way connection means, provided with aswitch that enables one to control the operation mode of the probe. Inthis way, the probe may also be used in the conventional manner, withnon-physiological pressure, depending upon the position of the switch.In this case, the cuff is inflated by injecting a fluid into one of theways of the connection means and remains permanently inflated.

The probe is further provided with a second monitoring cuff, locatedaround the first conduit, also linked to the inside of the first conduitin the region close to the opening of the tube that receives airinsufflation, which is inflated and deflated at the same rhythm as theinflation and deflation of the first cuff takes place. The second cuffis used for monitoring the functioning of the first cuff, since it willonly be inflated if the first cuff is intact. It is used mainly as ahypertension relief valve, since the cuff is elastic and extensible,absorbing any excess pressure, so that the cuff, at most, only restsagainst the trachea without damaging it. The trachea is more resistantthan the satellite cuff. For this reason, the satellite cuff expands andeven blows out in cases of too high pressure, making impossible thebarotraumas over the trachea walls.

Another probe embodiment is also provided, the probe having two tubescoupled side by side, one of them being longer than the other,permitting selective insulation of one lung, for example, by connectingan artificial breathing apparatus to one of the probe tubes andsimultaneously inflating the first cuffs of each tube, the first cuff ofthe first tube being close to the bronchia, and the first cuff of thesecond tube being in the trachea region, surrounding the two tubesaltogether. For this purpose, the air outlet of the tube cuff that isnot connected to the artificial breathing apparatus should be keptclosed. If, on the other hand, one wishes to effect the selectiveinflation of the other lung, for example, one connects the artificialbreathing apparatus to the other tube, closing the air outlet of thetube cuff that is not connected to said breathing apparatus.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a cross-section view of a first embodiment of the probe formedical use of the present invention, the figure illustrating the probetube, the first cuff, the first conduit located at the tube wall, havingan opening into the interior of the first cuff and an opening into theinterior of the tube, as well as the means that provide the tube with anelastic memory, which consists of a radiopaque flexible rod in thepreferred embodiment of the invention, which extends through the wholetube.

FIG. 2 is a top view from the AA′ section of the first probe embodimentillustrated in FIG. 1, which shows the first cuff, the first conduit,located at the tube wall along the length of the tube, and theradiopaque flexible rod.

FIG. 3 shows a cross-section view of a second probe embodiment accordingto the present invention, the figure illustrating the probe tube, thefirst cuff, the first conduit located at the tube wall, having anopening into the interior of the first cuff and an opening into theinterior of the tube, the radiopaque flexible rod and the second cuff,which monitors the functioning of the first cuff, and absorbs the excesspressure of the system, thus preventing hypertension in the first cuffand, consequently, tension of the first cuff in the trachea.

FIG. 4 is a cross-section view of a third probe embodiment of thepresent invention, illustrating, in addition to the components describedin FIG. 3 (probe tube, first cuff, first conduit located at the tubewall with an opening into the interior of the first cuff and a secondopening into the interior of the tube, radiopaque flexible rod andsecond cuff), the connection means, which enables the probe to be usedas a conventional probe, with active inflation of the first cuff bymeans of a syringe, or else with passive inflation of the first cuff atthe moment of inspiration with the physiological pressure of theairways, the backflow of air during expiration being immediately closed,thus maintaining the first cuff permanently inflated, but withphysiological pressure.

FIG. 5 shows a cross-section view of a fourth embodiment of a probe formedical use, which illustrates the probe tube, the first cuff, the firstconduit located at the tube wall, having an opening into the interior ofthe first cuff and an opening into the tube, the radiopaque flexiblerod, the second and third conduits, provided with bores and arranged atthe tube wall, through which the secretions existing inside and outsidethe probe tube are sucked, the first and second connection means, aswell as the second cuff for monitoring the first cuff.

FIG. 6 is a top view from the BB′ section of the fourth probe embodimentillustrated in FIG. 5, which shows the first cuff, the first conduit,the second conduit and the third conduit, located at the tube wall alongthe length of the tube, as well as the radiopaque flexible rodthroughout the whole tube.

FIG. 7 is a cross-section view showing, in detail, the second cuff,which communicates with the first conduit, which accounts for monitoringthe first cuff, besides being one of the main mechanisms of protectionof the trachea wall, since it prevents hypertension in the first cuff,which is elastic, distensible and has low resistance in its filling.

FIG. 8 is a cross-section view of a fifth embodiment of the probe of thepresent invention, illustrating, in addition to the components describedin FIG. 5 (probe tube, first cuff, first conduit, radiopaque flexiblerod, second and third conduits, first and second connection means andsecond cuff), the detail of a portion of the first conduit that isconnected to the second cuff and which is external to the tube wall andconcertina, whereby its length may be adjusted if it is necessary to cutthe probe or increasing it.

FIG. 9 shows another embodiment of the probe for medical use with thesame characteristics of the above-described embodiments, but furthercomprising a second tube similar to the first one, laterally coupled tothe first tube, having a shorter length than the latter and a firstconduit that communicates the interior of the second tube with theinterior of the first cuff of the second tube, said first conduitextending as far as the inside of the first cuff of the first tube. Themetallic guide remains located on the larger tube wall as far as itslip, or at the middle of the two tubes, and from this point to the tipof the larger tube.

DETAILED DESCRIPTION OF THE FIGURES

FIG. 1 illustrates a first embodiment of the probe for medical use ofthe present invention. This first embodiment comprises a tube 1,provided with at least one opening 2 to receive air insufflation, and afirst cuff 3, arranged around the tube 1 in a region of its externalwall, which is inflatable by means of a first conduit 5 arranged at thewall of the tube 1, having an opening into the interior of the firstcuff 3 and another opening into the interior of the tube 1. Theinflation of the first cuff 3 occurs by injecting a flow of air into theopening of the tube of the probe 2 during the inspiration, bringingabout the fixation of the probe to the walls of the passageway of thehuman body that is being intubated and principally sealing or occludingthe trachea, so that inspired air will not escape. The deflation of thefirst cuff 3, in turn, occurs in the period of time in which air isexpelled from the patient's lungs through the probe tube 1, that is,during the expiration, providing a relief of the mechanical pressurethat was being exerted by the first cuff 3 on the walls of saidpassageway of the human body and making blood circulation possible inthis region until a new flow of air is injected into the human body.Thus, the inflation and deflation of the first cuff 3 take placefollowing the rhythm itself of the patient's respiration (inspirationand expiration, respectively), which makes the probe physiologicallyideal. It should be pointed out that the flow of air insufflated intothe tube 1 of the probe may also come from an artificial breathingapparatus, on patients with mechanical ventilation or any ventilationmode, including awake patients breathing spontaneously with probe ortracheotomy.

In addition, FIG. 1 shows the means 4 that provide the probe tube 1 withan elastic memory, located at the tube wall along the length of the tube1. Such means 4 consist of a guide thread made from a flexible andradiopaque material, which enables one to mold the probe tube 1 and toview the probe in an X-ray photograph and to effect tracheal intubationwithout the use of a laryngoscope with patient's head and neck in anyangulations and/or position. This prevents serious injuries to lips,gums, teeth, nose wings and tracheostomy orifices, besides molding theprobe at the exit of the mouth and/or nose and/or tracheostomy orifice,or else other cannulas such as artery and vein cannulas used in heartsurgeries or any other types of surgery which needs a flexible plastictube with elastic memory.

This elastic memory imports to the tube an important purpose: making ita first option in emergency procedures such as CRA (cardio respiratoryarrest) and/or polytraumatisms and facial and cervical injuries, becauseit dispenses with the guide thread and the laryngoscope.

FIG. 2 is a top view from the section AA′ of the first probe embodimentillustrated in FIG. 1. In this figure, one illustrates the first cuff 3,arranged around the tube 1, and the first conduit 5, located at the tubewall along the length of the tube, which has an opening into theinterior of the first cuff 3 and a second opening into the interior ofthe tube 1 or else into the interior of a preferably Y-shaped connectorcoupled to the tube 1, or else coupled to an independent source from therespirator that has a cycle in the same rhythm of the breathing or elsespecific equipments for inflating and deflating the cuffs,synchronically with the cycle of the respirator.

FIG. 3 illustrates a second probe embodiment for medical use, which alsoconsists of a tube 1, which will receive air insufflation; a first cuff3, arranged around the tube 1, in a region of its external wall, saidfirst cuff 3 being inflatable by means of the conduit 5 arranged at thetube wall, having an opening into the interior of the first cuff 6 andanother opening into the interior of the tube 1; and means 4 thatprovide the probe tube 1 with an elastic memory, located at the tubewall along the length of the tube 1. It should be pointed out that theinflation and deflation of the first cuff 3 are effected by followingthe procedure described above for the first probe embodiment for medicaluse.

The probe of this second embodiment, illustrated in FIG. 3, is furtherprovided with a second cuff 16 for monitoring, which is also linked tothe inside of the first conduit 5 in the region close to the opening 2of the tube that receives air insufflation and is inflated and deflatedtogether with the first cuff 3. The second cuff 16 monitors thefunctioning of the first cuff 3, and is only inflated if the first cuff3 is intact. This satellite cuff 16 is elastic and extendable, workingmainly as relief valve for any excess pressure in the tracheal andbronchial cuffs, so that the most that can happen is for the cuffs torest against the tracheas, and never press upon them; since thesatellite has less resistance it will expand, absorbing the excesspressure. If the pressure is too great, the satellites will expand untilthey blow out and, even so, no injury will be caused to the tracheas bythe cuffs; which will only rest against it. This means that the tracheahas much higher distension than the satellite cuffs.

FIG. 4 illustrates a third probe embodiment for medical use, comprisingthe same elements of the probe embodiment of FIG. 3, described above.The inflation and deflation of the first cuff 3 is effected by the sameprocedure of the embodiment of the preceding figure.

In the probe embodiment of FIG. 4, the first conduit 5 is connected to aconnection means 20, provided with a switch that enables one to controlthe probe operation mode. In this way, the probe may also be used in aconventional manner, with non-physiological pressure, the first cuff 3being inflated, in this case, by insertion of a fluid and remainingpermanently inflated even if it is inflated with high pressure, the onethat will absorb the excess pressure is the satellite cuff and not thefirst cuff, that it to say, in any form of functioning there will neverbe hyperpressure in the cuffs against the wall of the bronchia andtrachea. The probe will further be used, with passive inflation of thefirst cuff 3 at the moment of inspiration, with the physiologicalpressure of the airways, the backflow of air and deflation of the firstcuff 3 being prevented by closing the connection means 20. In this way,the first cuff 3 remains permanently inflated, but with physiologicalpressure of the airways.

Another embodiment of the probe for medical use is shown in FIG. 5,which also comprises a tube 1, which will receive air insulation; afirst cuff 3, arranged around the tube 1 in a region of its externalwall, said first cuff 3 being inflatable through a first conduit 5arranged at the tube wall, having an opening into the interior of thefirst cuff 6 and another opening into the interior of the tube 1 or fromand direct source of respirator, or from Y connected to the probe or aspecific equipment to inflate and deflate the cuffs with low pressure,synchronically with the cycle of the respirator. The inflation anddeflation of the first cuff 3 are effected by following the sameprocedure described above for the first embodiment of a probe formedical use.

FIG. 5 also shows the means 4 that provide the probe tube 1 with anelastic memory, located at the tube wall along the length of the tube 1,consisting of a guide thread made from a flexible and radiopaquematerial that permits the molding of the probe tube 1, the viewing probein an X-ray photograph and the tracheal intubation without the use of alaryngoscope, and principally in emergencies for intubation, such as CRA(cardio respiratory arrest), polytraumatisms, facial and cervicalinjury, urgency tracheostomy, facilitates and expedites greatly theintubation procedure, since it dispenses with the guide and even thelaryngoscope, minutes or seconds less, which may represent the patient'slife, also preventing the risks of injuries caused by conventionalguides and laryngoscope when effected by inexperienced people, such asbreaking teeth, laceration of the gums, tongue, oropharynx, stomach,tracheal, bronchia, larynx, vocal cords and underlying organs such asthe aorta.

In addition, the probe embodiment shown in FIG. 5 further comprises asecond conduit 8 and a third conduit 10, located at the tube wall andextending along the length of said tube 1, said second conduit 8 beingprovided with bores 9 close to one of its ends, linking the interior ofthe tube with the interior of the second conduit 8, whereas the otherend is couplable to an external suction means, and the third conduit 10being provided with bores 11 close to one of its ends above the trachealcuff, linking the interior of the third conduit 10 to the externalregion of the tube 1, while the other end of the third conduit 10 iscouplable to an external suction means which may be automatic,continuous, intermittent, or manual, effected by the physician himselfor paramedical. In this way, the secretions existing inside the tube 1and in the external region of the tube 1 may be sucked through thesecond 8 and the third 10 conduits, respectively, thus preventing anyobstruction of the passageway for the flow of air that may be caused bythe presence of such secretions. The second 8 and third 10 conduits arealso connectable to a first 3-way connection means 12, provided with aswitch 13 for controlling the suction of secretions through the second 8and third 10 conduits 10, said first connection means 12 being coupledto an external suction means. Depending upon the position of the switch13, either the secretions located inside the tube 1 alone or thoselocated in the external region of the tube 1 alone can be sucked, or thesecretions of both the regions can be sucked at the same time.

According to an embodiment of the present invention, the first conduit 5is connectable to a second 3-way connection means 14, provided with aswitch 15 that enables one to control the probe operation mode. In thisway, the probe may also be used in the conventional manner, withnon-physiological pressure, depending upon the position of the switch15, the first cuff 3 being inflated, in this case, by inserting a fluidinto one of the ways for the second connection means 14, and remainingpermanently inflated, or else with passive inflation of the first cuff 3at the time of inspiration, with physiological pressure of the airways,the backflow of air and the deflation of the first cuff 3 beingprevented by closing the connection means 14. In this way, the firstcuff 3 remains permanently inflated, but with the physiological pressureof the airways.

The probe shown in FIG. 5 is further provided with a second cuff 16intended for monitoring, located around the first conduit 5, also linkedto the interior of the first conduit 5 in the region close to theopening 2 of the tube that receives air insufflation, which is inflatedand deflated in conjunction with the first cuff 3. The second cuff 16monitors the functioning of the first cuff 3 and is only inflated if thefirst cuff 3 is intact and is one of the elements responsible for thespecially non-traumatic nature of this probe, since it is elastic anddistensible, prevents, in any circumstance, the occurrence ofhyperpressure in the cuffs, thus preventing the risk of ischemia ormechanical trauma of the trachea by the cuff (preventing barotraumas).

FIG. 6 is a top view from the section BB′ of the probe embodimentillustrated in FIG. 5. This figure illustrates the first cuff 3, thefirst conduit 5, the second conduit 8 and the third conduit 10, arrangedat the tube wall along the length of the tube.

FIG. 7 shows a second cuff 16 similar to the first one 3, whichcommunicates with the first conduit 5 and is inflated and deflated inconjunction with the first cuff 3. The second cuff 16 is located closeto the end of the tube where the opening 2 that receives air insulationis located. The second cuff 16 is inflated and deflated at the samerhythm of the inflation and deflation of the first cuff 3, being usedfor monitoring the first cuff 3, since its inflation will only occur ifthe first cuff 3 is intact and functions as a relief valve for pressurepeaks, since it is elastic and distensible.

FIG. 8 illustrates a fifth embodiment of a probe for medical use, whichcomprises the same elements and has the same operation mode of the probeembodiment of FIG. 5, described above. However, in this probeembodiment, the first conduit 5 has a concertina portion 21 outside thetube wall, close to the end connected to the second cuff 16. In thisway, the length of the first conduit 5 may be adjusted, if it isnecessary to cut the probe in order to reduce the dead space or elseincrease it in order to increase the dead space.

FIG. 9 shows another embodiment of a probe for medical use with the samecharacteristics of the embodiments described above, but furthercomprising a second tube 17, similar to the first one 1, that is to say,being also provided with at least one opening for receiving airinsufflation, and a first cuff arranged around the two tubes 1 and 17 ina region of its external walls, inflatable through a first conduit 18arranged at the tube wall 17, having an opening into the interior of thefirst cuff and another opening into the interior of the tube 17, thisfirst conduit extending as far as the inside of the first cuff 3 of thefirst tube 1. The inflation and deflation of the first cuff of thesecond tube 17 and of the common tracheal cuff that involves the twotubes occurs in the same way described previously for the first cuff 3of the first tube 1. This second tube 17 is laterally coupled to thefirst tube 1 and is shorter than the first tube 1.

The conduits 5 and 18 which communicate the inside of the probe with thecuffs and that carry part of the inspired air to inflate them, shouldcompulsory show expansion at the rate of about ⅓ of the probe gage,being located at the thickness of the probe wall, so that they willproject inwards or outwards. This great gage, quite larger than that ofconventional probes, will cause the air-flow resistance to be low andthe cuffs to be inflated long before the air reaches the end of theprobe, guaranteeing that the trachea will be sealed and preventing wasteof the inspired gases. If the gage of these conduits is small, equal tothat of conventional probes, the resistance is great and the cuffs willnot be inflated and so the whole air inspired will leak around the probemaking it ineffective and inadequate for use.

In addition, the location of the air inlet of these ducts has to beeither at the proximal end of the probe or at a Y-connector, never nearthe cuff, be it tracheal or bronchial, for the following reasons:

-   -   (a) Being distant, the cuff will inflate long before the air        inspired reaches the probe tip, thus preventing waste of gas.        When the volume of air inspired represents the double volume of        air in the cuff, the latter will be filled, and the air has only        reached the extent of the probe that holds the same volume, that        is to say, never having reached the top. This is very important,        since otherwise the cuff does not inflate sufficiently to seal        the trachea and permit ventilation with positive pressure;    -   (b) The air inlet of the conduits that communicate with the        inside of the probe as cuff may never be at the most distal end        of the probe, near the cuff. In this case, the air inspired        would reach the top of the probes at a high speed and, instead        of inflating the cuff, the air will suck it by the Venturi        effect, drying it even more. The probe would be completely        ineffective, since the cuff would not inflate. Moreover, even if        the cuff inflated a little, this would be for a short time,        since this location and the size of its orifice would be factors        that would lead to its obstruction rapidly, as well as to an        almost immediate flooding of the cuff chamber by secretions,        which would make the probe ineffective;    -   (c) The angle of attack of the air inlet of the conduit that        communicates the cuffs with the tube lumen may never be in the        direction contrary to the flow of inspired air, not even at a        90-degree angle. It has to form an obtuse angle with respect to        the outer surface of the tube, that is to say, it has to be in        the same direction of the inspired air with the legs of the Y.        This is fundamental, otherwise the inspired air upon passing        through the orifice will generate a Venturi effect, which will        aspire the cuff and not inflate it.

LIST OF EMBODIMENTS

Embodiments—The following list includes particular embodiments of thepresent invention. But the list is not limiting and does not excludeembodiments otherwise described herein or alternate embodiments, aswould be appreciated by one of ordinary skill in the art.

1. An atraumatic cuff for use with a medical probe comprising:

a cuff conduit having an end adapted to link to a conduit of a tubehaving at least one opening for receiving air insufflation, the cuffconduit having an opening;

a cuff arranged around the cuff conduit in a region of its external walland in communication with the opening; said cuff being inflatablethrough the opening;

wherein the cuff conduit is adapted to be laterally coupled to anopening in a first tube of a medical probe through an inward hole in theproximal area of a tube of a medical probe in the region of the tubeclose to an opening for receiving air insufflation, and the cuff isadapted to inflate and deflate together with a second cuff on themedical probe.

2. The atraumatic cuff of embodiment 1, wherein the cuff is elastic andis distensible at low pressure.

3. The atraumatic cuff of any one or more of the preceding embodiments,wherein the atraumatic cuff is capable of monitoring the function of thesecond cuff, wherein the atraumatic cuff is only inflated when thesecond cuff is intact.

4. The atraumatic cuff of any one or more of the preceding embodiments,wherein the atraumatic cuff is adapted to absorb excess airway pressurein the second cuff.

5. The atraumatic cuff of any one or more of the preceding embodiments,wherein the cuff conduit includes a concertina portion extending fromthe cuff and toward the end adapted to link to the conduit of the tubeof the medical probe.

6. A probe with an atraumatic cuff for medical use comprising:

a first tube having at least one opening for receiving air insufflation;

a first cuff for the first tube arranged around the first tube in aregion of its external wall; said first cuff being inflatable through afirst conduit, wherein the first conduit of the first tube is incommunication with the interior of the first tube and is incommunication with the interior of the first cuff;

a cuff conduit having a cuff conduit opening in a wall of the cuffconduit, and coupled to the first tube through an inward hole in an areaof the tube proximal to the opening for receiving air insufflation, thatconnects to the first conduit; and

a second cuff arranged around the cuff conduit in a region of itsexternal wall and in communication with the cuff conduit opening, saidsecond cuff being inflatable through the first conduit;

wherein the second cuff is adapted to inflate and deflate together withthe first cuff of the first tube.

7. The probe of embodiment 6, wherein the first conduit of the firsttube is a passageway made in the wall of the first tube.

8. The probe of any one or more of embodiments 6-7, wherein the cuffconduit includes a concertina portion between the second cuff and theinward hole.

9. The probe of any one or more of embodiments 6-8, wherein the secondcuff is elastic and is distensible at low pressure.

10. The probe of any one or more of embodiments 6-9, wherein the secondcuff is inflated when the first cuff is intact.

11. The probe of any one or more of embodiments 6-10, wherein the secondcuff functions as a relief valve for excess airway pressure in the firstcuff.

12. The probe of any one or more of embodiments 6-11, comprisingradiopaques located along the wall of the first tube, wherein theradiopaques have elastic memory.

13. The of any one or more of embodiments 6-12, comprising a secondconduit at the first tube wall, which extends along the length of thefirst tube, being coupable to an external aspiration device, and having,close to one of the second conduit's ends, bores that communicate theinterior of the first tube with the interior of the second conduit.

14. The probe of embodiment 13, further comprising a third conduit atthe first tube wall, which extends along the length of the first tube,being coupable to an external aspiration device, and having, close toone of the third conduit's ends, bores that communicate the interior ofthe third conduit with the external region of the first tube.

15. A probe according to embodiment 14, wherein the second and thirdconduits are couplable to a 3-way connector, the connector beingconnected to the external aspiration device and having a switch thatcontrols aspiration of the second and third conduits.

16. A probe with an atraumatic cuff for medical use comprising:

a first tube having at least one opening for receiving air insufflation;

a first cuff, for the first tube arranged around the first tube in aregion of its external wall; the first cuff being inflatable through afirst conduit;

a second tube having at least one opening for receiving airinsufflation; the second tube being laterally coupled to the first tube;

a first cuff for the second tube, arranged around both the first tubeand the second tube in a region of their external walls, the first cufffor the second tube being inflatable through a first conduit of thesecond tube, wherein the first conduit of the first tube has an openinginto the interior of the first cuff for the first tube and anotheropening into the interior of the first tube; and the first conduit ofthe second tube has an opening into the interior of the first cuff forthe second tube and another opening into the interior of the second tubeand extends into the inside of the first cuff for the first tube;

a cuff conduit having a cuff conduit opening in a wall of the cuffconduit, and coupled to the first tube through an inward hole in an areaof the tube proximal to the opening for receiving air insufflation ofthe first tube that connects to the first conduit of the first tube; and

a cuff for the cuff conduit arranged around the cuff conduit in a regionof its external wall and in communication with the cuff conduit opening,the cuff for the cuff conduit being inflatable through the first conduitof first tube.

17. The probe of embodiment 16, wherein the cuff for the cuff conduit isadapted to inflate and deflate in conjunction with the first cuff forthe first tube and the cuff for the cuff conduit is located in theregion proximal to where the first tube receives air insufflation.

18. The probe of any one or more of embodiments 16-17, wherein the cufffor the cuff conduit has elasticity and is distensible at low pressure.

19. The probe any one or more of embodiments 16-18, wherein the cuff forthe cuff conduit is inflated when the first cuff is intact and functionsas a relief valve for excess airway pressure in the first cuff.

It should be understood that the probe for medical use and itscomponents described above are only a few embodiments that might exist.The real scope of the object of the invention is defined in theaccompanying claims.

What is claimed is:
 1. An atraumatic cuff for use with a medical probecomprising: a cuff conduit having an end adapted to link to a conduit ofa tube having at least one opening for receiving air insufflation, thecuff conduit having an opening; a cuff arranged around the cuff conduitin a region of its external wall and in communication with the opening;said cuff being inflatable through the opening; wherein the cuff conduitis adapted to be laterally coupled to an opening in a first tube of amedical probe through an inward hole in the proximal area of a tube of amedical probe in the region of the tube close to an opening forreceiving air insufflation, and the cuff is adapted to inflate anddeflate together with a second cuff on the medical probe.
 2. Theatraumatic cuff of claim 1, wherein the cuff is elastic and isdistensible at low pressure.
 3. The atraumatic cuff of claim 2, whereinthe atraumatic cuff is capable of monitoring the function of the secondcuff, wherein the atraumatic cuff is only inflated when the second cuffis intact.
 4. The atraumatic cuff of claim 3, wherein the atraumaticcuff is adapted to absorb excess airway pressure in the second cuff. 5.The atraumatic cuff of claim 1, wherein the cuff conduit includes aconcertina portion extending from the cuff and toward the end adapted tolink to the conduit of the tube of the medical probe.
 6. A probe with anatraumatic cuff for medical use comprising: a first tube having at leastone opening for receiving air insufflation; a first cuff for the firsttube arranged around the first tube in a region of its external wall;said first cuff being inflatable through a first conduit, wherein thefirst conduit of the first tube is in communication with the interior ofthe first tube and is in communication with the interior of the firstcuff; a cuff conduit having a cuff conduit opening in a wall of the cuffconduit, and coupled to the first tube through an inward hole in an areaof the tube proximal to the opening for receiving air insufflation, thatconnects to the first conduit; and a second cuff arranged around thecuff conduit in a region of its external wall and in communication withthe cuff conduit opening, said second cuff being inflatable through thefirst conduit; wherein the second cuff is adapted to inflate and deflatetogether with the first cuff of the first tube.
 7. The probe of claim 6,wherein the first conduit of the first tube is a passageway made in thewall of the first tube.
 8. The probe of claim 6, wherein the cuffconduit includes a concertina portion between the second cuff and theinward hole.
 9. The probe of claim 6, wherein the second cuff is elasticand is distensible at low pressure.
 10. The probe of claim 9, whereinthe second cuff is inflated when the first cuff is intact.
 11. The probeof claim 10, wherein the second cuff functions as a relief valve forexcess airway pressure in the first cuff.
 12. The probe of claim 6,comprising radiopaques located along the wall of the first tube, whereinthe radiopaques have elastic memory.
 13. The of claim 6, comprising asecond conduit at the first tube wall, which extends along the length ofthe first tube, being coupable to an external aspiration device, andhaving, close to one of the second conduit's ends, bores thatcommunicate the interior of the first tube with the interior of thesecond conduit.
 14. The probe of claim 13, further comprising a thirdconduit at the first tube wall, which extends along the length of thefirst tube, being coupable to an external aspiration device, and having,close to one of the third conduit's ends, bores that communicate theinterior of the third conduit with the external region of the firsttube.
 15. A probe according to claim 14, wherein the second and thirdconduits are couplable to a 3-way connector, the connector beingconnected to the external aspiration device and having a switch thatcontrols aspiration of the second and third conduits.
 16. A probe withan atraumatic cuff for medical use comprising: a first tube having atleast one opening for receiving air insufflation; a first cuff, for thefirst tube arranged around the first tube in a region of its externalwall; the first cuff being inflatable through a first conduit; a secondtube having at least one opening for receiving air insufflation; thesecond tube being laterally coupled to the first tube; a first cuff forthe second tube, arranged around both the first tube and the second tubein a region of their external walls, the first cuff for the second tubebeing inflatable through a first conduit of the second tube, wherein thefirst conduit of the first tube has an opening into the interior of thefirst cuff for the first tube and another opening into the interior ofthe first tube; and the first conduit of the second tube has an openinginto the interior of the first cuff for the second tube and anotheropening into the interior of the second tube and extends into the insideof the first cuff for the first tube; a cuff conduit having a cuffconduit opening in a wall of the cuff conduit, and coupled to the firsttube through an inward hole in an area of the tube proximal to theopening for receiving air insufflation of the first tube that connectsto the first conduit of the first tube; and a cuff for the cuff conduitarranged around the cuff conduit in a region of its external wall and incommunication with the cuff conduit opening, the cuff for the cuffconduit being inflatable through the first conduit of first tube. 17.The probe of claim 16, wherein the cuff for the cuff conduit is adaptedto inflate and deflate in conjunction with the first cuff for the firsttube and the cuff for the cuff conduit is located in the region proximalto where the first tube receives air insufflation.
 18. The probe ofclaim 17, wherein the cuff for the cuff conduit has elasticity and isdistensible at low pressure.
 19. The probe of claim 18, wherein the cufffor the cuff conduit is inflated when the first cuff is intact andfunctions as a relief valve for excess airway pressure in the firstcuff.